PURPOSE OF THE JOBManages the day-to-day activities of the Analytics & Data Science department. Serves as the primary contact and resource for staff. Provides oversight, direction, development, problem resolution, and leadership for the Analytics & Data Science team.
The team's responsibilities include:
- Transforming data into meaningful and actionable information for various customer segments
- Performing strategic data analysis to support medical management programs, quality and value-based partnerships, and a strategic and predictable corporate provider reimbursement strategy
- Establishing measurement standards
- Identifying previously unknown relationships within data to support analyses of trends and healthcare issues
QUALIFICATIONSREQUIRED QUALIFICATIONSRequired Work ExperienceSupervisor - 3 years of experience in data science, data analytics and reporting, or scientific analysis
- 1 year of experience in a supervisory or management field and/or project management
Manager- 5 years of experience in data science, data analytics and reporting, or scientific analysis
- 3 years of experience in a supervisory or management role
Senior Manager- 10 years of experience in data science, data analytics and reporting, or scientific analysis
- 7 years of experience in a management role
Required Education- Bachelor's degree in business, mathematics, statistics, healthcare administration, or a related field of study (All Levels)
Required LicensesRequired CertificationsPREFERRED QUALIFICATIONSPreferred Work ExperienceSupervisor- 3 years of experience in a management or leadership role
- 1 year of experience in the insurance or healthcare field
Manager- 5 years of experience in a management or leadership role
- 3 years of experience in the insurance or healthcare field
Senior Manager- 10 years of experience in a management or leadership role
- 7 years of experience in the insurance or healthcare field
Preferred Education- Master's degree in business, mathematics, computer science, or a related field of study (All Levels)
Preferred LicensesPreferred Certifications- SAS Certification
- Tableau Certification
- Associate of the Society of Actuaries (ASA)
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES- Manage the day-to-day operations of the department.
- Administer, interpret, and maintain current working knowledge of required BCBSAZ systems, procedures, forms, and manuals related to the assigned area of responsibility.
- Review, update, and maintain the accuracy of department documentation, computer files, policies, and procedures related to department goals and objectives.
- Keep staff informed of new or updated standards, systems, procedures, forms, and manuals through staff meetings and verbal and written communications.
- Direct, evaluate, define, and improve quality, quantity, and timeliness standards to achieve individual and department performance goals as defined within department guidelines.
- Provide guidance, motivation, and encouragement to staff.
- Conduct performance evaluations, identify and coordinate training needs, and evaluate and make recommendations regarding employment decisions.
- Consult and coordinate with internal departments, external Blue Plans, business partners, and government agencies.
- Identify and create appropriate technical solutions to address business issues.
- Monitor external economic and healthcare issues affecting trends and prepare succinct, easy-to-understand presentations of results and conclusions.
- Serve as an internal consultant to help define analytical needs and assist end users with interpreting and applying analytical results.
- Explore relevant data sources to determine which metrics can be produced.
- Prepare succinct, easy-to-understand presentations of results and conclusions.
- Analyze, interpret, and communicate information, and present results in formats that facilitate decisions and actions.
- Assist with developing new performance measurement tools and approaches.
- Maintain current knowledge of emerging measurement standards.
- Evaluate analytical findings to ensure accurate data interpretation and the development of meaningful data-mining results.
- Research the latest developments from governmental and national entities, including CMS, NCQA, AHRQ, and Leapfrog, regarding the establishment of metrics used to monitor and/or define provider quality information for the general public.
- Present research findings and recommendations in written and verbal formats.
- Lead the team in analyzing and mining multiple data sources, selecting statistically valid data samples, and building, testing, and implementing statistical models by investigating appropriate methods and algorithms.
- Effectively summarize and present findings to executive leadership to drive business decisions.
- Design custom dashboards for various areas of the company.
- Research and define key metrics and data sources.
- Monitor dashboards for continued effectiveness and improvement opportunities.
- Identify and create business tools and analytical solutions to address business issues.
- The position has an onsite expectation of 2 days per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Perform all other duties as assigned.
COMPETENCIESREQUIRED COMPETENCIESRequired Job Skills- Intermediate PC proficiency
- Intermediate skill in using office equipment, including copiers, fax machines, scanners, and telephones
- Basic skill in word-processing and presentation software
- Intermediate proficiency in database, spreadsheet, statistical analysis, query and data-mining, and business intelligence software
- Advanced project management skills
- Advanced mathematics and statistics skills
- Working knowledge of classification tools, including ICDs, DRGs, ACGs, and ETGs
Required Professional Competencies- Maintain confidentiality and privacy
- Communicate professionally with internal and external customers
- Analytical skills in observing and documenting processes at a detailed level
- Proficiency in process improvement and business process design
- Analyze and research data and propose solutions to resolve issues
- Ability to use a variety of classification tools and manipulate large quantities of data
- Establish, contribute to, and maintain a positive and productive work environment
- Ability to plan, organize, and manage the work of assigned personnel
- Advanced knowledge of HRIS systems, employment law, and HR regulations
Required Leadership Experience and Competencies- Ability to optimize resources to ensure a cost-effective operation, including proactively planning to move staff from one role to another as staffing needs, business priorities, or workload changes
- Ability to build effective teams
- Ability to implement new processes and procedures
PREFERRED COMPETENCIESPreferred Job Skills- Advanced proficiency in database, spreadsheet, statistical analysis, query and data-mining, business intelligence software including SAS, and data visualization tools such as Tableau
Preferred Professional CompetenciesPreferred Leadership Experience and Competencies- Ability to establish and maintain professional relationships with community and professional groups that reflect favorably on the department and BCBSAZ.
